Judah Schiller lost his wife three days after their son was born. Here, he shares his story to draw attention to the more than 400 women in the U.S. who will die this year from pregnancy or birth-related causes. The United States has thee WORST death and illness rates for new mothers and babies of any developed nation. It also has morbidity and mortality rates that are higher than several undeveloped nations. Birth in United States hospitals is more dangerous than in any other developed country. There is no reason for this to continue.
We have the knowledge and the resources to provide much better, mother-friendly and baby-friendly care to women and their little ones - prenatally, during birth, and postnatally in our country. As Dr. Marsden Wagner (former director of the World Health Organization's department of Women & Children's Health) says, "[The United State's] broken maternity system MUST be fixed to put women and children first" - or we will continue to see tragedies all around us such as this.
When Judah Schiller talks about how he met his wife, Galit, his voice gets soft. "I was 25 at the time and scuba diving in the Red Sea," the executive vice president of Saatchi & Saatchi S reminisces. "You can imagine: pillows, campfire, the beautiful water, the brown hues of the desert. I was sitting there trying to charm these two very lovely French models, and Galit sat down a few pillows away from us. She was a very pretty woman, and I could tell she was kind of eavesdropping, so I invited her to join the conversation."
The models left, and the couple watched the sun set over the Sinai Mountains, beginning a charmed courtship that resulted in their 1998 marriage. Shortly afterward, they settled in San Francisco, where their first son, Tomer, was born in 1999. In 2002, they had their daughter, Naomi.
By June 2007, Israeli-born Galit was 35 years old, one class away from being certified as an Iyengar-yoga instructor, and the Schillers were celebrating the arrival of their third child, another boy they named Satya. Judah recalls, "This was the easiest birth of the three, and she seemed to recover quickly. The kids came to the hospital and she felt good."
The new mother stayed in the hospital for about a day and a half, a typical recovery period for vaginal deliveries, before returning home. By the next evening, life seemed back to normal. "My parents had come up, and it was one of those warm Bay Area kind of June days," says Judah. "We were outside on our deck having champagne, thankful and happy that we had had a healthy baby."
However, during dinner, Galit began to feel pressure in her diaphragm and chest area. Within the hour, the pain had gotten so bad that she asked to be taken to the hospital. As Judah helped her into the car, she passed out, unconscious. Although the paramedics came quickly and rushed Galit to the emergency room, she died later that evening. "There was a lot of internal bleeding, and everything just spiraled," he says sadly.
But one of the most agonizing moments came the next morning. "The kids came in to snuggle and play at 7:00 a.m., and I had been in the hospital till midnight watching my wife — their mother — die. The newborn had to be fed every few hours, and I didn't have a bottle in the house because breast-feeding was the plan. The older children had seen the ambulance come the night before, and their first question was 'Where's Ima?'" he explains, using the Hebrew word for mother. "I said, 'Ima died last night.'"
Sadly, the case of Galit Schiller is all too familiar in the United States, where, in spite of access to the best medical care in the world, the rate of maternal death related to pregnancy or birth almost doubled between 1990 and 2005.
The cause of death varies from woman to woman. Some result from infection, some hypertension, some septic shock, and some amniotic-fluid embolism, a complication in which amniotic fluid or other matter re-enters the mother's bloodstream, triggering a reaction that can result in cardiorespiratory arrest and hemorrhaging. In one chilling coincidence in 2007, a New Jersey town witnessed the death of two friends, Valerie Scythes and Melissa Farah, teachers at the same school who gave birth at the same hospital and died of childbirth-related complications within two weeks of each other (reportedly of a blocked blood vessel and internal bleeding, respectively).
Unfortunately for the Schillers, the results of Galit's autopsy were inconclusive. "I was sort of disgusted with the way the coroner's proceedings were held," Judah maintains.
Regardless of how maternal deaths occur, the Centers for Disease Control has estimated that more than half of them could be avoided by early diagnosis and treatment. Ina May Gaskin, a certified professional midwife who is considered one of the leading experts on the subject, says, "They used to keep women in the hospital for 10 days after birth because they were so worried about complications. By the '60s, they shortened that to five days, and in the early '90s suddenly the hospitals switched and made everyone get out in two or three days." Regardless of our modern aspirations to superwoman strength, Gaskin contends that two days is not enough. "You're home, you're still hurting, you could be infected, you could still have something in your uterus. All these things can be dangerous, and they can be easily fixed if you spot the trouble in time."
Gaskin's recommendation is a simple combination of rest and at-home check-ins for the mother by a postpartum doula, nurse, or midwife for several days after delivery — a program that is de rigueur in the Netherlands, where, according to a 2007 report compiled by several U.N. agencies, a woman's estimated lifetime risk of dying as a result of pregnancy- and childbirth-related complications is one in 10,200. In the U.S., the number is one in 4,800.
Of course, some insurance plans are loath to cover the cost of additional maternal care. In fact, the current system makes it easy to underestimate the problem. Not every state asks doctors to report if a woman was pregnant or recently gave birth on a death certificate, and there is no federal legislation mandating maternal-mortality review committees at a state level. In fact, the CDC estimated in 1998 that the U.S. maternal death rate between 1982 and 1996 was 1.3 to 3 times that reported in vital-statistics records.
"When you see women who have the best insurance losing their lives, you know there is something really, really wrong," says Gaskin. "Nurses could easily be brought up to speed on postpartum care, and we'd have all kinds of people to do that work. It would be so easy for insurance companies to cover that. Even if it saved as few as 20 lives a year, wouldn't it be money well spent?"
Gaskin strongly believes that it is up to individuals to take control of their health care by asking the right questions and to the country as a whole to demand solutions that will prompt Congress to effect change.
But, says Judah, "If it happens here to someone healthy, at a first-class hospital, imagine what it's like in a developing country."
As a result, organizations like the White Ribbon Alliance for Safe Motherhood, a coalition of medical professionals and others from 140 countries, are working on behalf of women worldwide. In July, WRA members launched a campaign urging G8 leaders to pledge an additional $10 billion per year to meet the U.N.'s fifth Millennium Development Goal, which is committed to cutting global maternal mortality by 75 percent by 2015 (as compared with 1990). The campaign includes Sarah Brown, wife of British prime minister Gordon Brown and co-chair of the Maternal Mortality Leadership Group as well as global patron of the WRA; Naomi Campbell; and Gwyneth Paltrow. As Sarah Brown says, "The G8 in Italy has just delivered a much firmer political consensus on maternal health. What the U.N. must deliver is leadership for this issue at the heart of achieving all the Millennium Development Goals, funding for training health workers, and improving access for women wherever they are vulnerable."
Back in San Francisco, the Schillers have tried to move on with their lives, but Judah works hard to preserve the children's memories of their mother. "It's something I've had the great pleasure and the great displeasure to think deeply about," he says philosophically. "We talk about how she was good at playing horse and she was really competitive at Ping-Pong. My daughter has a hard time remembering what her hair felt like or the softness of her skin but will remember a pair of striped corduroy pants that she had.
"Taking your kids to their mother's grave is not the kind of relationship you want them to have with her," Judah concedes. "But you have to celebrate what remains."
A GLOBAL CONCERN
"When you save a mother's life, you save the best person to raise her children, feed, clothe, vaccinate, and educate them, and also contribute to her community, her economy, her environment," Sarah Brown says. "Save the mothers and you can save the world."
- Every minute of every day, somewhere in the world, a woman dies of pregnancy-or birth-related complications — more than half a million women each year.
- The world mortality rate is higher now than in 2000. As many as one in six women in parts of Africa dies from pregnancy- or birth-related complications.
- In 2007, the World Health Organization reported that 40 countries have lower maternal death rates than the U.S.
WHAT YOU CAN DO
- Visit whiteribbonalliance.org to learn how you can support the WRA.
- Write to your congressperson or local newspaper in support of maternal-health legislation.
- Review, Know, Support the Mother-friendly and Baby-friendly Childbirth & Hospital Initiatives going on nationwide.
- Review, Know, Support a Midwifery Model of Care for birthing mothers and their babies.
- Become fully informed of your pregnancy and birth options, the statistics related with each, and make conscious decisions with a supportive birth group of your choice - including a doula to ensure others around support YOUR birth choices.
- Review, Know, Support access to certified, birth professionals - the experts in normal human birth.
It would be great if you could include www.rememberthemothers.netReplyDelete
This site is dedicated to improving maternal mortality.
As a mother to almost 5 children, this is the saddest and most real fear I have. After having my 4th child, I had to be rushed to the hospital not once, but twice for retained products. The doctors that attended my birth were in such a hurry to deliver my placenta, they didn't realize they left a chunk of placenta in my uterus. I would have died both times if my husband wasn't a trauma trained firefighter, he is solely responsible for saving my life. I had a d&c at 11 days and 22 days postpartum. I had to have multiple blood transfusions and spent time in the ICU. I am shocked at how, in America, we must be in fear for our lives delivering a baby at a major medical center.ReplyDelete
As I await the birth of my 5th child, my only concern is the doctors and nurses ability to correctly deliver my baby and placenta.
Thank you for the story. I came very close to losing my life after delivering my first (and only) son by emergency cesarian. For reasons unknown my uterus wouldn not contract and I continued to hemmorage. I lost conciousness and the doctors had to perform an emergency hysterectomy - the only way left to save my life. I spent 2 days in intensive care and a week in the hospital, and I had 7 blood transfusions. Women think that birth is so easy, many don't realize how dangerous it can become.ReplyDelete
That is so incredibly tragic. We need to be careful here, though - without knowing the details of Galit's delivery, and with such a sudden onset of symptoms, it's very difficult to say if her death was preventable in any real-world sense.ReplyDelete
Her death could also be used as a justification to mandate hospital birth - as rushing her to hospital was not timely enough to save her - and prolonged hospital stays. This may have saved Galit, but could result in the deaths of countless other mothers through unnecessary interventions. There is always risk with birth, but by cutting out unnecessary interventions we can reduce risk overall, but increase the risk to individuals with rare complications.
I found my hospital stay detrimental to sleep, bonding, my nutrition and the development of breastfeeding, and if we had decided to have another child I would not have chosen a hospital birth - but I would have accepted that I would have been at a disadvantage had complications arisen that were better treated in a hospital environment.
Judah, none of this analysis helps you or your children. I am so sorry for your loss.
"Birth is not a beginning;
death is not an end.
There is existence without limitation".
Amy, I love what you had to say.ReplyDelete